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UTMB scientist is headed into the Ebola hot zone

GALVESTON — At a time when most are fleeing the outbreak of Ebola in West Africa, one of Galveston’s own is flying in.

Thomas Ksiazek, director of high containment laboratory operations for the Galveston National Laboratory at the University of Texas Medical Branch, will leave for Sierra Leone on Aug. 11 to lead U.S. Centers for Disease Control and Prevention Ebola outbreak control operations, assisting the government of Sierra Leone.

His role is part of a massive effort being supported by research and medical professionals from the CDC as well as from other institutions from around the world.

Ksiazek is director of the National Biodefense Training Center and a world-renowned virus expert with 40 years of experience on the front lines of some of the worst outbreaks the world has ever seen.

Before coming to the medical branch, he was chief of the Special Pathogens Branch at the CDC in Atlanta where he coordinated outbreak and control responses to especially dangerous pathogens such as Ebola, Marburg and SARS. In fact, he codiscovered the SARS virus.

Through the years, he has played a significant role in disease discovery and outbreak response efforts in Asia, Africa, South America and the Middle East.

Sierra Leone is where the worst of the current Ebola outbreak is centered. Ksiazek will not be treating patients. As a veterinarian, epidemiologist and expert on exotic diseases in international and developing world settings, he will be looking to contain the current epidemic.

He recently answered questions specific to his impending deployment for The Galveston Daily News.

Q: What will you be doing in Sierra Leone?

A: I will be helping the CDC lead a team of epidemiologists that have been requested by the government of Sierra Leone to assist them in controlling the Ebola outbreak.

The nature of the work will be to find all the patients and make sure they are being cared for in some way that excludes contact with those who aren’t wearing protective gear of a type that won’t stop transmission.

The current problem appears to be that the network for finding and identifying all the patients has been pretty leaky. So the idea is to strengthen that network and the ability to find cases and make sure the contacts are under observation. So we will find patients and identify who they have had contact with and then maintain contact with those people.

Q: This is the biggest and deadliest outbreak of Ebola we’ve seen. Are you concerned for your safety?

A: I’ve been on many of these field trips; I’m not concerned for my personal safety. Essentially all the cases are the result of direct, unprotected contact with patients or lapses in the protocol that people are supposed to follow; so outside of that, walking around in a village or town where there’s Ebola is not a dangerous affair. Even my wife isn’t that worried.

There’s a lot of hype surrounding these viruses, and, in my opinion, it’s overblown based on the nature of what really goes on. Everyone is terrified of this virus. But if aerosol transmissions were its natural form of transmission, entire towns would be wiped out. That’s not the case. There a lot more people dying of malaria in Africa than from the pathogen causing this outbreak.

Q: Will the work of your group help stop the spread of Ebola and help prevent another outbreak?

A: We learn from every outbreak. It all began in 1976 with two outbreaks in what was northern Zaire at the time and southern Sudan.

They turned out to be two different viruses. Another outbreak in 1979 in Sudan and a single case in 1977 northern Zaire. And that was it until 1995 when there was an outbreak in Kikwit, Zaire. I was there for about six weeks.

During that time, we learned a lot and it really changed the paradigm of how we understand the way Ebola is transmitted. We know now that we need to identify the patients, find them and those they’ve been in contact with who have been infected and get them into a treatment facility in order to stop them from transmitting it to others.

We need to up the chances of getting people into a hospital. This won’t prevent another outbreak. But if you catch it early you can limit the number of cases.

The protocols are now in place — early diagnosis, identification of patients and handling them in such a way that transmission does not occur. That way you control an outbreak of the scope we’re talking about now.

Q: Shouldn’t this kind of response occurred months ago?

A: There were people who went in months ago. The problem is that the work wasn’t done with the rigor and intensity that’s required.

It’s always a challenge to work in these areas; you can’t go in and declare you’re in charge here. You have to work with your partners and get the lay of the land. Largely, I’m concerned with the organization of the operation.

I’ll be coordinating the people, but the partnerships include the CDC, the Ministry of Health, volunteers and local recruits. It’s a huge effort.

Hopefully, at the end of my month in Sierra Leone, I will have helped create an organizational scheme with functional teams, see that assignments are made, that databases are set up to generate reports for each area with contacts and follow-up with village leaders and sick people.

Q: Any final thoughts?

A: There is a dilemma here. We have drugs and vaccines that are effective in primates here at the GNL and in other labs similar to ours but they have not undergone the regulatory scrutiny to be used in humans.

Some people would say it’s unethical to use these drugs on individuals, but I think it may come to a point where we have to consider it. A lot of that work to show that these vaccines are effective is being done here at the GNL.

We are contributing to positive outcomes. Hopefully this outbreak can be brought under control in a couple of months. I’m excited about the opportunity to help.

You go out on these field trips and some people think it’s stressful; I actually find it less stressful than the environment I normally work in. I’ll get to focus on the mission.
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Thomas Ksiazek

In addition to his work for the Galveston National Laboratory, Thomas Ksiazek is a professor in the departments of pathology and microbiology and immunology at the University of Texas Medical Branch.

Ksiazek is the author of more than 350 research papers.

He has a bachelor’s degree in biological sciences and a DVM from Kansas State University, a master’s degree in virology from the University of Wisconsin, Madison, and a Ph.D. in epidemiology/virology from the University of California, Berkeley.
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At a glance

Thomas Ksiazek, director of high containment laboratory operations for the Galveston National Laboratory at the University of Texas Medical Branch, will leave for Sierra Leone on Aug. 11 to lead Ebola outbreak containment operations for the U.S. Centers for Disease Control and Prevention. Ksiazek advises other epidemiologists in 2007 during an Ebola outbreak in Luebo, Democratic Republic of the Congo.